A new study has recently been released in the Journal of the American Medical Association about some of the reasons behind the continued decline in the average life expectancy of those living in the USA. It showed that the decline is mainly due to the group of "working-age" Americans, those aged 25-64, who are increasingly at risk of dying of drug abuse, suicide, hypertension and a wide variety of organ system diseases. These latter causes are particularly prevalent among individuals who did not complete high school. Indeed, the decline in life expectancy is now so sustained that the US is rapidly falling behind other wealthy countries – the decline among working-aged adults has not been seen in other countries and is a "distinctly American phenomenon" said study co-author Steven H. Woolf of Virginia Commonwealth University School of Medicine.
The study looked at five decades of data on US life expectancy and found that, although US life expectancy increased from 1959 until 2011, it plateaued from then until 2014 and has declined since then. What the study shows is that the divergence between the USA and other wealthy countries began in the 1980s when the US life expectancy started to grow more slowly than its peers. Woolf puts this down to the beginning of the opioid epidemic, the shrinking of the middle class and the widening of income inequality. While many nations saw economic shifts in the 1980s, there was less of a safety net in the US than elsewhere. Woolf argued that
"In other countries, families that fall on hard times have programs and services available to cushion the blow. In America, people often have to fend for themselves."
Howard Koh of the Harvard T.H. Chan School of Public Health also notes that other countries spend relatively more in terms of social services which not only help people to get to the doctor, but also help with other, less tangible, ways of supporting life: social connections and strong community networks.
The decline in life expectancy is not spread evenly throughout the country. It is felt most heavily in parts of New England, including Maine, New Hampshire and Vermont and also in the "Ohio Valley": Indiana, Kentucky, Ohio and Pennsylvania. (More than one-third of all excess deaths since 2010 in the US have taken place in the Ohio Valley states.) These areas were most affected by the collapse of the US manufacturing sector and have seen the worst of the opioid epidemic. In contrasts, the life expectancy of those living along the Pacific coast increased from 2010 to 2017.
Overall though, the outlook is grim. As Koh says, it was always assumed that life expectancy would always increase in the future. Now the US "risks a future in which declining life expectancy may be the new norm".